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PCOS Symptoms (Now Called PMOS): Signs, Causes, Diagnosis & Treatment

PCOS (polycystic ovary syndrome) is a common hormonal and metabolic condition that affects about one in eight women. The main signs are irregular or missed periods, acne, excess facial or body hair, thinning scalp hair, weight gain around the waist and difficulty getting pregnant. It also raises the long-term risk of type 2 diabetes, heart disease and mood problems. In May 2026, an international consensus published in The Lancet gave PCOS a new name, polyendocrine metabolic ovarian syndrome (PMOS), because many women with the condition do not have ovarian cysts at all. There is no cure, but with a healthy lifestyle and the right treatment, most women can manage their symptoms well. This guide explains the symptoms (tanda-tanda PCOS), causes, how it is diagnosed, treatment options and when to see a doctor.

What is PCOS (now PMOS)?

PCOS is a condition in which hormone signals between the brain, ovaries and other organs are out of balance. Women with PCOS often have higher levels of male hormones (androgens) and insulin resistance, which means the body needs more insulin to keep blood sugar normal. As a result, the ovaries may not release an egg every month, leading to irregular periods.

Why the new name? The name "polycystic ovary syndrome" suggested that the problem is cysts on the ovaries. In reality, the small "cysts" seen on scans are immature follicles, many women with the condition do not have them, and the condition affects hormones and metabolism throughout the body. After a global process involving more than 14,000 people with PCOS and health professionals, a consensus published in The Lancet in May 2026 chose the new name polyendocrine metabolic ovarian syndrome (PMOS). The change is being introduced gradually, so you will see both names for some time; this article uses PCOS because it is still the term most people search for.

What are the symptoms of PCOS?

Symptoms vary a lot from one woman to another, and you do not need all of them to have PCOS:

  • Irregular periods: cycles longer than about 35 days, fewer than eight periods a year, or no periods at all. If your period is late and you could be pregnant, see our guide to the early signs of pregnancy. For other causes of a late period, see our guide to period lambat.
  • Excess hair growth (hirsutism) on the face, chin, chest, stomach or back.
  • Acne, often on the jawline, that persists beyond the teenage years. See our jerawat guide for treatment options.
  • Thinning hair on the scalp, usually on the top of the head. Our guide to rambut gugur (hair loss in women) explains other causes too.
  • Weight gain, especially around the waist, and finding it harder to lose weight.
  • Dark, velvety patches of skin on the neck, armpits or groin, a sign of insulin resistance.
  • Difficulty getting pregnant, because ovulation is irregular.
  • Low mood, anxiety and poor sleep, which are very common in PCOS.

PCOS is not only a condition of women with excess weight; women of normal weight can have it too.

What causes PCOS?

The exact cause is not fully understood, but PCOS involves a mix of:

  • Genes: it often runs in families.
  • Higher androgen levels, which affect ovulation, skin and hair.
  • Insulin resistance, which drives the ovaries to make more androgens; weight gain makes insulin resistance worse, which can worsen symptoms.

PCOS is not caused by anything you did, and it is not contagious.

How is PCOS diagnosed?

In adults, doctors usually diagnose PCOS when you have at least two of these three features, after other causes have been ruled out:

  1. Irregular or absent ovulation, shown by irregular periods.
  2. High androgens, either on a blood test or as symptoms such as excess hair or acne.
  3. Polycystic ovaries on ultrasound, or, under the 2023 international guideline, a raised anti-Müllerian hormone (AMH) blood test as an alternative to ultrasound in adults.

In teenagers, ultrasound and AMH are not used for diagnosis, because many young women naturally have irregular cycles and many follicles. Your doctor may also check thyroid function, prolactin and other hormones to rule out conditions that look similar, and test your blood sugar and cholesterol.

Long-term health risks

The 2023 international guideline highlights that PCOS is more than a reproductive condition. Women with PCOS have higher risks of:

  • Type 2 diabetes and gestational diabetes
  • High blood pressure, unhealthy cholesterol levels and heart disease
  • Sleep apnoea (pauses in breathing during sleep)
  • Depression, anxiety and eating disorders
  • Complications in pregnancy, such as high blood pressure and diabetes in pregnancy
  • Thickening of the womb lining when periods are very infrequent, which over time raises the risk of endometrial cancer

Regular check-ups for blood sugar, blood pressure and cholesterol help catch problems early. Our guide to kolesterol tinggi explains what your cholesterol results mean.

How is PCOS managed?

Treatment depends on your main concerns, such as irregular periods, skin and hair symptoms, weight, or getting pregnant, and your doctor will tailor it to you. Common options include:

  • Healthy lifestyle as the foundation for everyone (see below).
  • The combined contraceptive pill to regulate periods, protect the womb lining and reduce acne and excess hair.
  • Metformin, a diabetes medicine that improves insulin resistance, often alongside lifestyle changes, especially for women with excess weight or metabolic risk.
  • Treatments for hair and skin, such as anti-androgen medicines, topical treatments and hair removal methods.
  • Fertility treatment, usually starting with medicines that help you ovulate, under the care of a doctor or fertility specialist.
  • Support for mood and sleep, including screening for depression, anxiety and sleep apnoea.

Be careful with products that promise to "cure PCOS" or "balance hormones" quickly. Supplements such as inositol are popular, but the evidence is still limited, so discuss them with your doctor. Some slimming products sold in Malaysia have been found to contain banned drugs; our guide to weight loss supplements and slimming pills explains how to check a product with NPRA.

Diet, weight and lifestyle

The international guideline emphasises a healthy lifestyle and emotional wellbeing for all women with PCOS, without weight stigma. Practical steps:

  • Eat balanced meals built around vegetables, lean protein and whole grains, and cut down on sugary drinks and refined snacks. There is no single "PCOS diet" that works better than general healthy eating.
  • Watch portion sizes of rice, noodles and fried food, which are easy to overeat. Our Malaysian food calories list shows how popular dishes compare.
  • Include protein at each meal to stay full; see our list of protein foods in Malaysia.
  • Move regularly: aim for at least 150 minutes of moderate activity a week, plus some muscle-strengthening exercise.
  • If you have excess weight, even modest weight loss can improve periods, ovulation and metabolic health. A structured plan, such as using a meal replacement for one meal a day, can help some people, ideally with advice from a doctor or dietitian.
  • Prioritise sleep and stress management, as both affect hormones and appetite.
  • Planning a pregnancy? Speak to your doctor early and start folic acid as advised; see folic acid for pregnancy.

When to see a doctor

See a doctor or gynaecologist if you:

  • have periods more than 35 days apart, fewer than eight a year, or none for three months (when not pregnant);
  • notice new or worsening excess hair, persistent acne or scalp hair thinning;
  • have been trying to get pregnant for 12 months (or 6 months if you are 35 or older);
  • have dark velvety skin patches, unexplained weight gain or symptoms of diabetes such as excessive thirst;
  • feel persistently low, anxious or have disordered eating.

If painful periods are your main concern, our guide to senggugut (period pain) explains what helps and when pain is not normal.

Frequently asked questions (FAQ)

What is PCOS?

Polycystic ovary syndrome (PCOS) is a common hormonal and metabolic condition that affects about one in eight women. It can cause irregular periods, signs of higher male hormones such as acne and excess hair, difficulty getting pregnant and a higher risk of diabetes. In 2026 it was given a new name, polyendocrine metabolic ovarian syndrome (PMOS).

What are the first signs of PCOS?

The most common early signs are irregular, infrequent or absent periods, acne, excess hair on the face, chin, chest or stomach, thinning hair on the scalp, and weight gain, especially around the waist. Not everyone has all of these, and some women only find out when they have trouble getting pregnant.

Why was PCOS renamed PMOS?

A global consensus published in The Lancet in May 2026 renamed it polyendocrine metabolic ovarian syndrome because the old name wrongly implied ovarian cysts and hid its hormonal and metabolic features. Many people with the condition do not have cysts. The change is being introduced gradually, so you will see both names for some time.

Can you have PCOS without cysts on the ovaries?

Yes. The "cysts" seen on ultrasound are actually many small, immature follicles, and they are only one of the possible criteria. PCOS can be diagnosed from irregular periods plus high male hormone levels or symptoms, without any ultrasound findings.

Can PCOS be cured?

There is no cure, but PCOS can be managed well. A healthy lifestyle, and when needed medicines such as the contraceptive pill, metformin or fertility treatment, can control symptoms and lower long-term risks such as type 2 diabetes.

Can I get pregnant if I have PCOS?

Many women with PCOS do get pregnant, sometimes naturally and sometimes with help such as ovulation-inducing medicine. Because PCOS raises the risk of complications in pregnancy, talk to your doctor before trying to conceive, and take folic acid as recommended.

Does losing weight help PCOS?

For women with excess weight, even modest weight loss can improve periods, ovulation and metabolic health. But PCOS also affects women of normal weight, and healthy eating, regular activity and good sleep help everyone with PCOS, whatever their size.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor, gynaecologist or dietitian. Health supplements are not intended to diagnose, treat, cure or prevent any disease.

References

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